66 results on '"Caffarena JM"'
Search Results
2. Trasplante cardíaco en el ventrículo único
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Ana Martín García, Luis Almenar, M Palencia, Caffarena Jm, Ana Osa, Pascual Malo, and Algarra F
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Humanities - Abstract
El corazon univentricular es una cardiopatia congenita poco frecuente. Un grupo seleccionado de estos pacientes (aquellos que ademas presentan una estenosis o atresia pulmonar) puede llegar a la edad adulta con mayor o menor incidencia de insuficiencia cardiaca o hipoxemia cronica severa. Los pacientes con un desarrollo adecuado del arbol pulmonar pueden ser subsidiarios de un trasplante cardiaco, en caso de estar contraindicadas las tecnicas habituales de paliacion. Presentamos tres casos de corazon univentricular y estenosis pulmonar en los que se indico un trasplante cardiaco como mejor opcion. Asi mismo, analizamos las distintas tecnicas disponibles para la valoracion del desarrollo del arbol pulmonar y su utilidad.
- Published
- 1998
3. Variables predictoras de mortalidad precoz tras el trasplante cardíaco ortotópico en adultos
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Luis Almenar, Caffarena Jm, Ana Osa, Luis Martínez-Dolz, Francisco Varela, Algarra F, Jesús Gómez-Plana, José Luis Vicente, Salvador Torregrosa, and M Palencia
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Gynecology ,medicine.medical_specialty ,business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objetivo El proposito de este estudio fue analizarvariables del donante, receptor y quirurgicaspara descubrir factores que pudieran predecir mortalidaddurante la fase precoz ( Material y metodo Se analizaron 125 trasplantescardiacos ortotopicos consecutivos de adultos. Laedad media fue de 51 ± 11 anos (rango, 12-67), 109fueron varones (87%) y 16 mujeres (13%). Se compararondos grupos segun los pacientes hubieranfallecido o no durante los primeros 30 dias tras eltrasplante cardiaco (15 y 110 pacientes, respectivamente). Protocolo inmunosupresor: en el preoperatorio,ciclosporina mas azatioprina. En el intraoperatorio,metilprednisolona. En el postoperatorio, metilprednisolona(primeras 24 h), anticuerpos monoclonalesantilinfociticos (7-10 dias posterioresal trasplante), ciclosporina, azatioprina y corticoides. Se analizaron los siguientes parametros del receptor:sexo, edad, peso, talla, perimetro toracico,cardiopatia de base, intervenciones toracicas previas,estadio funcional o necesidad de catecolaminaslos dias previos al trasplante, presiones y resistenciaspulmonares, historia de hipertensionarterial sistemica, elevacion de creatinina, gruposanguineo, trasplante realizado de forma urgente yrelacion de peso receptor/donante. Se analizaronlos siguientes parametros del donante y la intervencion:sexo, edad, peso, perimetro toracico, diasde estancia en cuidados criticos, dosis de dopaminay dobutamina, grupo sanguineo, procedencia delorgano, causa de muerte, tiempo de isquemia y circulacionextracorporea y tipo de cardioplejia. Resultados La tasa de mortalidad precoz ennuestra serie fue del 12%. En el analisis univariantese observaron diferencias en cuanto a los antecedentesde cirugia cardiovascular, grupo sanguineodel receptor, necesidad de realizar eltrasplante de una forma urgente, resistencias vascularespulmonares superiores a 2,5 UW, tiempo decirculacion extracorporea y la relacion de pesosentre el receptor y el donante. Se aproximo a lasignificacion la causa de muerte del donante. Elanalisis multivariante senalo, como parametros convalor predictivo independiente de mortalidad precoz,los antecedentes de intervencion con circulacionextracorporea, las resistencias vascularespulmonares elevadas, el trasplante urgente, la relacionde pesos receptor/donante y el tiempo de circulacionextracorporea. Conclusiones Pensamos que los resultados denuestra experiencia pueden ayudar a estratificar elriesgo ante un receptor de trasplante cardiaco ortotopico,e incluso contraindicar el procedimientoen determinados casos con acumulacion de factoresde mal pronostico en receptores «limite».
- Published
- 1997
4. Long-term clinical experience with the Omnicarbon prosthetic valve
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José M. Caffarena, Jose M Maroñas, Caffarena Jm, Ramón Frı́as, José Peris, Jesús Gómez-Plana, García-Sánchez F, Salvador Torregrosa, and Francisco J. Valera
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Pulmonary and Respiratory Medicine ,Aortic valve ,Adult ,Male ,Reoperation ,medicine.medical_specialty ,Anemia, Hemolytic ,Adolescent ,Anemia ,medicine.medical_treatment ,Pannus ,Dehiscence ,Postoperative Hemorrhage ,Prosthesis ,Postoperative Complications ,Mitral valve ,Thromboembolism ,Medicine ,Humans ,Child ,Survival rate ,Aged ,Heart Valve Prosthesis Implantation ,Endocarditis ,business.industry ,Incidence (epidemiology) ,Anticoagulants ,Middle Aged ,medicine.disease ,Surgery ,Prosthesis Failure ,Survival Rate ,medicine.anatomical_structure ,Child, Preschool ,Heart Valve Prosthesis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background . From February 1985 to December 1994, 781 Omnicarbon valve prostheses were implanted in 647 patients. These were 357 male and 290 female patients with a mean age of 53.5 ± 10.5 years (range, 4 to 78 years). Before operation, 81% of the patients were in New York Heart Association class III or IV, 16% were in class II, and only 3% were in class I. Methods . There were 227 aortic valve replacements (AVR) (35%), 286 mitral valve replacements (MVR) (44%), and 134 double-valve replacements (DVR) (21%) (AVR + MVR). Follow-up was 96.3% complete and consisted of 2,746 patient-years (mean follow-up, 4.6 years, and maximum follow-up, 10.7 years). Results . Hospital mortality rates were 7.0% for AVR, 8.0% for MVR, and 8.2% for DVR. The annualized rate of anticoagulant-related hemorrhage was 0.8% per patient-year, and thromboembolism occurred at a rate of 0.7% per patient-year. No structural failure was observed during 10-year follow-up. Twenty-one instances of nonstructural dysfunction (two, pannus growth, and 19, dehiscence) of the Omnicarbon valve occurred in 20 patients, an incidence of 0.8% per patient-year. Hemolytic anemia was observed only in the presence of valvular dehiscence (6 of 19). Eight patients (0.3% per patient-year) had development of prosthetic valve endocarditis (4, AVR; 2, MVR; and 2 DVR). At the end of 10 years of follow-up, 91% of the survivors were in New York Heart Association class I or II. The overall survival rate at 10 years was 82.5% ± 2.6% (85.0% ± 3.9%, AVR; 81.0% ± 4.1%, MVR; and 82.5% ± 2.6%, DVR). Considering only valve-related deaths, the survival rate at 10 years was 91.9% ± 2.4% (90.0% ± 2.7%, AVR; 93.1% ± 3.8%, MVR; and 90.0% ± 1.8%, DVR). Conclusions . Clinical results over a 10-year follow-up are excellent with the Omnicarbon prosthesis.
- Published
- 1999
5. Aorta-right atrial communication
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Marques Jl, Such M, Caffarena Jm, and Coto Eo
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Aorta ,business.industry ,Fistula ,medicine.disease ,Pseudoaneurysm ,Aneurysm ,Internal medicine ,medicine.artery ,Right coronary artery ,Ascending aorta ,cardiovascular system ,medicine ,Cardiology ,Surgery ,cardiovascular diseases ,Persistent left superior vena cava ,Cardiology and Cardiovascular Medicine ,business ,Coronary sinus - Abstract
An unusual aneurysmal aorta-right atrial communication was found in a 25-year-old man with a rounded mass in the right cardiophrenic angle. Differential diagnoses included ruptured aneurysm of the sinus of Valsalva, coronary arteriovenous fistula, rupture of a dissecting aneurysm of the ascending aorta into the right atrium, and pseudoaneurysm of the right coronary artery followed by formation of a fistula between the aneurysm and the right atrium. Closure of the communication was performed under cardiopulmonary bypass. Complete absence of the right superior vena cava with a large persistent left superior vena cava draining to the coronary sinus was an unexpected finding at operation. The origin of the communication is not known; possible anomalous coronary and noncoronary origins are considered.
- Published
- 1980
6. Double outlet right ventricle with L-position of the aorta, D-loop, subaortic VSD, and pulmonary stenosis
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Concha M, Ferrer H, F G Sanchez, Otero E, Peris Jj, Caffarena Jm, Gómez-Ullate Jm, Montero A, and Frias R
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Heart Defects, Congenital ,Heart Septal Defects, Ventricular ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Heart Ventricles ,Double outlet right ventricle ,medicine.artery ,Internal medicine ,medicine ,Humans ,Child ,Aorta ,Heart septal defect ,Cardiopulmonary Bypass ,business.industry ,Myocardium ,Angiocardiography ,medicine.disease ,Pulmonary Valve Stenosis ,Stenosis ,medicine.anatomical_structure ,Ventricle ,Right coronary artery ,Pulmonary valve stenosis ,Pulmonary artery ,cardiovascular system ,Cardiology ,Female ,business ,Research Article - Abstract
We describe a case of double outlet right ventricle with subaortic ventricular septal defect and pulmonary stenosis treated successfully with cardiopulmonary bypass. We consider the clinical history and angiocardiographic and surgical findings of this rare anomaly. We stress the difficulties of reconstruction of the outflow tract of the right ventricle, because of the anomalous pathway of the right coronary artery, the posterior situation of the pulmonary artery, and the abnormal anatomy present in the outflow tract of the right ventricle.
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- 1976
7. Mitral Valve Replacement and Splenectomy in a Patient with Chronic Idiopathic Thrombocytopenic Purpura
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Marońas Jm, Llamas P, and Caffarena Jm
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Splenectomy ,Platelet Transfusion ,law.invention ,Valve replacement ,law ,Mitral valve ,Cardiopulmonary bypass ,Humans ,Medicine ,Blood Transfusion ,Cardiopulmonary Bypass ,Platelet Count ,business.industry ,Mitral valve replacement ,Middle Aged ,medicine.disease ,Thrombocytopenic purpura ,Surgery ,Platelet transfusion ,medicine.anatomical_structure ,Purpura, Thrombocytopenic ,Heart Valve Prosthesis ,Heart failure ,Chronic Disease ,Mitral Valve ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
We report the management of a patient with chronic idiopathic thrombocytopenic purpura and mitral valve disease. Although a two-stage approach was planned (splenectomy followed by mitral valve replacement one month later), the patient developed medically-resistant heart failure, and splenectomy plus mitral valve replacement were performed during the same operation. The platelet count at operation was 20,000/mm3. Platelet transfusion, used at the end of cardiopulmonary bypass, was considered no longer necessary in the postoperative period, as the platelet count quickly increased after the first postoperative day. The postoperative course was uneventful. Though we believe the two-stage surgical approach is preferable, our case shows that open-heart operations and splenectomy can be successfully performed simultaneously in patients with idiopathic thrombocytopenic purpura.
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- 1982
8. Idiopathic dilatation of the right atrium: a not so benign entity.
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Walter C, Bartrons J, Gómez O, Caffarena JM, and Carretero JM
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- Arrhythmias, Cardiac, Child, Preschool, Dilatation, Dilatation, Pathologic, Female, Humans, Pregnancy, Aneurysm, Heart Atria diagnostic imaging
- Abstract
Idiopathic dilatation of the right atrium is an isolated enlargement of the right atrium in the absence of other cardiac lesions. This rare anomaly has a clinical spectrum ranging from asymptomatic to heart failure or even sudden death. It can be associated with atrial arrhythmias and thrombus formation. Antiplatelet therapy is prescribed in most cases reported in the literature, and reduction plasty is indicated when there is rapid growth of the right atrium, compression of adjacent structures, or refractory arrhythmias. We report four cases of idiopathic dilatation of the right atrium diagnosed during prenatal screening. We describe the intrauterine course and management in postnatal life until early childhood.
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- 2020
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9. A Rare Case of Cardiogenic Shock: Cor Triatriatum With Anomalous Pulmonary Venous Return.
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Moscoso B, Congiu S, Mayol J, Walter C, and Caffarena JM
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- Cor Triatriatum complications, Heart Atria surgery, Heart Defects, Congenital complications, Heart Defects, Congenital surgery, Humans, Infant, Newborn, Male, Pulmonary Veins abnormalities, Pulmonary Veins surgery, Scimitar Syndrome complications, Shock, Cardiogenic complications, Cor Triatriatum surgery, Scimitar Syndrome surgery, Shock, Cardiogenic surgery
- Abstract
Obstructive total anomalous pulmonary venous return (TAPVR) is a potentially life-threatening clinical condition and a surgical emergency. Left-sided partial anomalous pulmonary venous return (PAPVR) in association with a subdivided left atrium, also known as cor triatriatum sinister (CTS), is a very rare malformation that can mimic obstructive TAPVR. We present a case of a newborn with clinical manifestation of cardiogenic shock caused by CTS and PAPVR.
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- 2019
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10. Surgical closure of multiple large apical ventricular septal defects: how we do it.
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Perez-Negueruela C, Carretero J, Mayol J, and Caffarena JM
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- Adolescent, Child, Child, Preschool, Echocardiography, Female, Heart Septal Defects, Ventricular diagnosis, Heart Ventricles diagnostic imaging, Humans, Male, Treatment Outcome, Cardiac Surgical Procedures methods, Heart Septal Defects, Ventricular surgery, Heart Ventricles surgery
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The management of apical ventricular septal defects continues to be challenging because of the difficulty in achieving a complete closure without a left apical ventriculotomy. In this study, we present our innovative technique of closing multiple and/or large muscular apical ventricular septal defects through a right atriotomy. We operated three patients with multiple apical muscular trabecular ventricular septal defects ("Swiss cheese") using a technique that involved exclusion of the right ventricular apex. Their ages ranged between 2 months and 13 years. The VSDs were approached through right atriotomy. The trans right atrial approach using a 5-0 polypropylene purse-string suture or a two-patch procedure is a novel method of closing large apical ventricular septal defects. It was found to be effective with no persistent residual defects and did not have the disadvantages of a ventriculotomy.
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- 2017
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11. [Aorto-cavitary fistulae in infective native valve endocarditis].
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Fernández L, Carretero J, Prada F, and Caffarena JM
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- Child, Humans, Male, Aortic Diseases etiology, Cardiomyopathies etiology, Endocarditis, Bacterial complications, Fistula etiology, Staphylococcal Infections complications, Vascular Fistula etiology
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- 2015
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12. [Surgical treatment of anomalous left pulmonary artery].
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Carretero JM, Huertas M, Prada F, Rissech M, Jiménez L, Bartrons J, Mayol J, and Caffarena JM
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- Ductus Arteriosus, Patent complications, Ductus Arteriosus, Patent surgery, Echocardiography, Female, Heart Defects, Congenital surgery, Humans, Infant, Infant, Newborn, Magnetic Resonance Imaging, Male, Pulmonary Artery abnormalities, Tomography, X-Ray Computed, Treatment Outcome, Pulmonary Artery surgery, Vascular Surgical Procedures
- Abstract
We report our experience with the surgical treatment of anomalous origin of the left pulmonary artery in eight children between 2004 and 2009. The congenital heart disease most frequently associated with this condition was patent ductus arteriosus. Surgery was carried out with extracorporeal circulation in five children, and without, in three. The anomalous pulmonary artery was divided and translocated to the main pulmonary artery. One patient died soon after surgery because of hemodynamic instability and another died later because of respiratory complications. The other patients progressed satisfactorily during follow-up: the reimplanted artery remained patent in all cases and respiratory symptoms improved. However, one patient required endoscopic treatment., (Copyright © 2010 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.)
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- 2011
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13. Norwood-sano operation using a stentless pulmonary valved conduit.
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Ginestar AC, Martinez FS, Argudo JA, and Calvar JM
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The Sano modification of Norwood's operation has the potential to generate an excess volume load on the single right ventricle as a consequence of diastolic reversal of flow through the conduit. This article describes the use of a new, small, biological conduit with a porcine valve inside. This new conduit has been used in modified Norwood procedures. It is interposed between the right ventricle and the confluence of the pulmonary arteries. The use of a valved conduit should prevent the retrograde diastolic blood flow observed with use of nonvalved conduits and may improve postoperative hemodynamics. The use of a new stentless valved conduit in 3 recent Norwood procedures is reported herein.
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- 2011
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14. Treatment of complex coarctation of aorta with hypoplastic transverse aortic arch using left carotid artery flap.
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Arrieta EJ, Martínez FS, Mayol J, and Caffarena JM
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- Abnormalities, Multiple pathology, Aorta, Thoracic abnormalities, Aorta, Thoracic pathology, Aortic Coarctation pathology, Cardiac Catheterization, Echocardiography, Doppler, Humans, Infant, Newborn, Treatment Outcome, Abnormalities, Multiple surgery, Aorta, Thoracic surgery, Aortic Coarctation surgery, Carotid Arteries transplantation, Surgical Flaps
- Abstract
Coarctation of aorta associated with severe hypoplastic aortic arch and ductus arteriosus dependent, often combined with complex cardiac malformations, should be looked upon as bordering of hypoplastic left heart syndrome. The crucial and first objective is the adequate reconstruction of aortic arch, continuing with the repair of cardiac malformations. The surgical treatment making resection of the coarctation segment combined with left carotid flap plasty is a surgical alternative, useful in patients with this complex anatomic variant.
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- 2009
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15. Long-term storage in liquid nitrogen does not affect cell viability in cardiac valve allografts.
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Mirabet V, Carda C, Solves P, Novella-Maestre E, Carbonell-Uberos F, Caffarena JM, Hornero F, Montero JA, and Roig RJ
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- Adolescent, Adult, Cell Culture Techniques, Child, Cryoprotective Agents pharmacology, Dimethyl Sulfoxide pharmacology, Female, Flow Cytometry, Heart Valves ultrastructure, Humans, Male, Microscopy, Confocal, Middle Aged, Serum Albumin pharmacology, Time Factors, Transplantation, Homologous, Young Adult, Cell Survival physiology, Cryopreservation methods, Heart Valves physiology, Nitrogen, Tissue Preservation methods
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Liquid nitrogen is the most common medium used by tissue banks for the storage of cryopreserved heart valves. This study evaluates the effect of the length of storage on human cryopreserved heart valves. Human tissues (14 aortic and 13 pulmonary) were frozen in a controlled-rate freezer (1 degrees C/min) and stored in the liquid phase of a nitrogen tank for 9.1+/-1.6 years. The preservative solution was medium M199 containing 5% human serum albumin and 10% Me(2)SO. After thawing in a water bath at 42 degrees C, the cryoprotectant was removed. Then, fragments from vascular wall and leaflet were dissected. Explant cultures and histological studies were performed in order to assess cell viability and structural integrity. CD90 and CD31 expression was analysed in cultured cells using flow cytometry. Light microscopy, immunofluorescence staining and laser scanning confocal microscopy were used to evaluate cell viability and extracellular matrix components. Electron microscopy was used for ultrastructural study. Cell cultures could be obtained from all the specimens assayed. Cells grew from explants showing a fibroblastic phenotype. CD90 expression was common in cultured cells but a low percentage of cells expressed CD31. Histological results showed a good preservation estructure in both leaflets and vascular walls. Morphological features of cellular irreversible damage were very rare. No differences which could be due to length of allograft storage period were observed. We concluded that allografts stored in liquid nitrogen up to 13 years did not significantly undergo loss of cell viability other than that due to disinfection, freezing and thawing protocols.
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- 2008
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16. Successful neonatal double switch in symptomatic patients with congenitally corrected transposition of the great arteries.
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Bautista-Hernandez V, Serrano F, Palacios JM, and Caffarena JM
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- Follow-Up Studies, Heart Defects, Congenital diagnostic imaging, Heart Defects, Congenital surgery, Humans, Infant, Newborn, Male, Risk Assessment, Treatment Outcome, Ultrasonography, Cardiac Surgical Procedures methods, Transposition of Great Vessels diagnostic imaging, Transposition of Great Vessels surgery
- Abstract
Anatomic repair is the standard surgical approach to congenitally corrected transposition of the great arteries. However, timing to perform the procedure remains controversial. We present 2 cases of congenitally corrected transposition of the great arteries and Ebstein's-like anomaly of the tricuspid valve presenting with heart failure. Both cases had successful anatomic repair during the neonatal period.
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- 2008
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17. Device migration in hybrid technique for apical muscular ventricular septal defects closure.
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García-Valentín A, Congiu S, Mayol J, Prada F, Mortera C, Pomar JL, and Caffarena JM
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- Cardiopulmonary Bypass, Device Removal, Echocardiography, Doppler, Equipment Design, Female, Foreign-Body Migration diagnostic imaging, Foreign-Body Migration surgery, Heart Septal Defects, Ventricular diagnostic imaging, Humans, Infant, Newborn, Treatment Outcome, Cardiac Surgical Procedures instrumentation, Foreign-Body Migration etiology, Heart Septal Defects, Ventricular surgery
- Abstract
Muscular ventricular septal defects still require complex surgical procedures for their repair. We have used a hybrid approach for closure of these ventricular septal defects in patients needing open-heart surgery. It consists of the deployment of a ventricular septal occluder, as used in transcatheter procedures inside the defect under direct vision after cardiopulmonary bypass establishment. Through this paper, we report a case to illustrate a new and simple technique to avoid one of the most dramatic complications after this procedure: the migration of the closure device.
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- 2007
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18. Biventricular repair of complete atrioventricular canal, double-outlet right ventricle and common atrium using a modified double switch technique. A valid alternative to univentricular procedure.
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Caffarena JM and Gómez-Ullate JM
- Abstract
An eleven month-old child underwent a successful modified double switch operation for total correction of complete atrioventricular canal, double outlet right ventricle, noncommitted ventricular septal defect, pulmonary stenosis, common atrium and anomalous left superior vena cava to an unroofed coronary sinus. We describe the technique of modified double switch operation, utilizing an atrial switch combined with a Rastelli type reconstruction between the venous ventricle and the pulmonary artery.
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- 2005
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19. [Percutaneous closure of ventricular septal defect with an Amplatzer device].
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Mortera C, Prada F, Rissech M, Bartrons J, Mayol J, and Caffarena JM
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- Adult, Cardiac Catheterization methods, Cardiac Surgical Procedures instrumentation, Child, Child, Preschool, Echocardiography, Doppler, Female, Heart Septal Defects, Ventricular diagnostic imaging, Heart Septal Defects, Ventricular pathology, Heart Ventricles diagnostic imaging, Heart Ventricles pathology, Heart Ventricles surgery, Humans, Infant, Male, Minimally Invasive Surgical Procedures instrumentation, Treatment Outcome, Cardiac Surgical Procedures methods, Heart Septal Defects, Ventricular surgery, Minimally Invasive Surgical Procedures methods, Prostheses and Implants
- Abstract
We present a series of 4 patients in whom a ventricular septal defect (VSD) was closed with an Amplatzer muscular VSD device during cardiac catheterization. In one patient with type I truncus arteriosus and subarterial VSD, closure of a wide apical defect was done to allow further surgical correction while avoiding left ventricular ventriculotomy. The second patient had congenitally corrected transposition of the great arteries with complete A-V block and a pacemaker implanted from birth. Our intention was unload the systemic anatomical right ventricle. The third patient had had 3 heart surgeries to correct a double outlet right ventricle. She had a residual ventricular septal defect which was large enough to cause heart failure. The last patient had an isolated muscular ventricular septal defect. Percutaneous closure was successful in all patients, and there were no complications. Percutaneous closure of the defect may be used as a primary procedure, before surgery, or as a complementary procedure after surgery.
- Published
- 2004
20. Comprehensive experience with the Ross operation in Spain.
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Concha M, Pradas G, Juffé A, Caffarena JM, Montero A, and Aranda PJ
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- Adolescent, Adult, Age Distribution, Aortic Valve Insufficiency surgery, Bioprosthesis, Cardiac Surgical Procedures methods, Cause of Death, Child, Child, Preschool, Disease-Free Survival, Female, Follow-Up Studies, Heart Valve Prosthesis, Humans, Infant, Male, Middle Aged, Postoperative Complications, Registries, Spain, Survival Analysis, Treatment Outcome, Aortic Valve surgery, Heart Valve Diseases surgery, Pulmonary Valve transplantation
- Abstract
Objective: Although the first pulmonary autograft operations were performed in Spain in 1991, this procedure has gained substantial interest and has been consolidated since 1997. The establishment of the Spanish Registry of the Ross Operation pretends to evaluate the results of this option in aortic valve disease patients in our setting., Methods: In a yearly fashion, the cardiac surgery departments in Spain currently performing this intervention send data from new patients or follow-ups to the reference center. Preoperative, intraoperative and postoperative data are included in the registry, with special attention to morbidity, mortality, autograft and homograft dysfunction and need for reintervention., Results: Since February 1991 to May 2002, 169 patients have been treated with this technique. The most prevalent aortic disease was regurgitation (72; 42.59%), congenital being the most frequent etiology (108; 63.9%). Four (2.36%) patients required intraoperative aortic counterpulsation. Operative mortality was 2.36% (n=4). Follow-up is 98.7% complete, with an average of 36.08+/-31.09 months (range 1-135), 84 patients (49.7%) were followed for more than 2 years. The autograft remains competent or with trivial to mild regurgitation in 161 patients (95.6%), presenting two (1.18%) with severe regurgitation. The homograft was normal or with mild stenosis in 159 patients (94.07%), presenting five (2.95%) with severe stenosis. Three (1.77%) required reintervention (surgical or interventional) on the right ventricular outflow tract and four (2.36%) required autograft replacement for a mechanical prosthesis. Actuarial survival is 95.99+/-1.65% at 36 months, remaining 92.44+/-2.55% free from reintervention in the same period., Conclusions: The Ross operation is an increasingly popular surgical option in Spain, and although the number of patients and length of follow-up are still limited, initial results are at least as good as those reported internationally. It is important to continue a close follow-up of these patients to assess the long-term function of auto and homograft. With the available data, we believe that this therapeutic approach is a valid option for selected groups of patients with surgical aortic valve disease in Spain.
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- 2003
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21. Mitral annular and left ventricular outflow tract enlargement with autologous tissue: extended application of the Ross-Konno procedure.
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Caffarena JM, Rovirosa M, and Gòmez-Ullate JM
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- Aortic Stenosis, Subvalvular complications, Aortic Stenosis, Subvalvular diagnosis, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnosis, Child, Coronary Angiography, Echocardiography, Humans, Male, Mitral Valve Stenosis complications, Mitral Valve Stenosis diagnosis, Patient Selection, Reoperation methods, Transplantation, Autologous methods, Treatment Outcome, Ventricular Outflow Obstruction complications, Ventricular Outflow Obstruction diagnosis, Aortic Stenosis, Subvalvular surgery, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation methods, Mitral Valve Stenosis surgery, Pulmonary Veins transplantation, Surgical Flaps, Ventricular Outflow Obstruction surgery
- Published
- 2003
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22. [Analysis of factors that can influence the appearance of acute heart transplant failure].
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Martínez-Dolz L, Almenar L, Arnau MA, Osa A, Rueda J, Vicente JL, García-Sánchez F, Palencia M, and Caffarena JM
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- Acute Disease, Female, Graft Rejection epidemiology, Heart Transplantation mortality, Heart Transplantation statistics & numerical data, Humans, Male, Middle Aged, Multivariate Analysis, Risk Factors, Graft Rejection etiology, Heart Transplantation adverse effects
- Abstract
Introduction and Objective: Acute graft failure (AGF) is defined as significant failure of myocardial function in a newly implanted heart. The aim of the present study was to investigate a series of factors related to heart transplantation (HT) in relation to AGF., Material and Method: In a study of 287 consecutive HTs performed over a 14-year period, AGF was defined when: a) the surgeon observed ventricular dysfunction before closing the sternotomy; b) various inotropic drugs were required at high doses in the first days after surgery, or c) ventricular dysfunction was identified by routine echocardiography in the immediate postoperative period. Statistical analysis comprised a descriptive and univariate comparative study, followed by multivariate analysis based on application of a logistical regression model., Results: The incidence of AGF was 22%. Predictors of AGF were female donor status (OR = 2.2; 95% CI, 1.2-4.4; p = 0.02), a disproportion of more than 20% in donor-recipient body weight (OR = 2.2; 95% CI, 1.1-4.3; p = 0.02), and background ischemic heart disease (OR = 2.5; 95% CI, 5.5-1.1; p = 0.03) or valve pathology (OR = 5.0; 95% CI, 7.0-1.5; p = 0.01)., Conclusions: AGF is a frequent pathology, which was present in 22% of our heart transplantation patients. Among the modifiable factors related to AGF was a clear disproportion in body weight and the size of grafts from female donors. Unmodifiable factors related to AGF were ischemic heart disease and valvular heart disease as a cause of heart transplantation.
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- 2003
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23. DORV with non-committed VSD and Taussig-Bing hearts. Controversial anatomic entities.
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Caffarena JM and Gómez-Ullate JM
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- Double Outlet Right Ventricle pathology, Heart Septal Defects, Ventricular pathology, Humans, Infant, Newborn, Heart Defects, Congenital pathology, Myocardium pathology
- Published
- 2003
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24. Long-term outcome after valve replacement with the omnicarbon prosthesis.
- Author
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di Summa M, Poletti G, Brero L, Centofanti P, La Torre M, Patanè F, Raggio JM, Sanchez FG, Maroñas JM, Torregrosa S, Valera FJ, and Caffarena J Jr
- Subjects
- Adult, Aged, Aortic Valve physiopathology, Aortic Valve surgery, Cohort Studies, Female, Follow-Up Studies, Heart Valve Diseases diagnosis, Heart Valve Diseases mortality, Humans, Linear Models, Male, Middle Aged, Mitral Valve physiopathology, Probability, Prospective Studies, Prosthesis Failure, Reoperation, Survival Analysis, Treatment Outcome, Bioprosthesis, Heart Valve Diseases surgery, Heart Valve Prosthesis, Mitral Valve surgery, Postoperative Complications mortality, Quality of Life
- Abstract
Background and Aim of the Study: The study aim was to determine whether long-term prognosis was affected by valve replacement with a tilting-disc prosthesis., Methods: Surgical data were recorded prospectively for all (n = 153) valve replacement cases with the Omnicarbon prosthesis during the period February 1985 to January 1986. A rheumatic valvular pathology was present in 105 patients (68.6%). There were 78 (51%) aortic (AVR), 51 (33%) mitral (MVR) and 24 (16%) double (DVR) valve replacements. The follow up was 99% complete (n = 151)., Results: Mean follow up was 10.2+/-4.4 years (total 1,472 patient-years (pt-yr)). Survival at 10 years was 68+/-4% (71+/-5% AVR, 61+/-7% MVR), and this fell to 57+/-4% at 14 years. No structural failure was observed. Thromboembolic and hemorrhagic events were rare, with actuarial freedom from thromboembolism of 94+/-2% and 91+/-3% at 10 and 14 years, respectively. This low incidence of thromboembolism encouraged an ease in anticoagulation; hence the AVR and MVR cohorts had a median INR of 2.8, but a higher INR (3.4) was maintained in DVR patients. All prostheses had acceptable hemodynamic performance. No cases of hemolytic anemia were detected, and mean blood counts were within normal ranges. Lactate dehydrogenase values indicated minimal hemolysis, and were lowest after AVR (median LDH 93% normal) and highest after DVR (median LDH 136% normal). Functional evaluation showed an improvement in NYHA class that remained stable over 14 years. At follow up, 95% (75/79) of patients were in NYHA class I or II., Conclusion: Survival and quality of life after Omnicarbon valve implantation exceeded the authors' expectations. Functional capacity remains good, and valve-related complication rates are low. The Omnicarbon tilting-disc valve has been shown to provide reliable and satisfactory service in the long term.
- Published
- 2002
25. Long-term clinical experience with the Omnicarbon prosthetic valve.
- Author
-
Torregrosa S, Gómez-Plana J, Valera FJ, Caffarena J, Maroñas JM, García-Sánchez F, Peris J, Frías R, and Caffarena JM
- Subjects
- Adolescent, Adult, Aged, Anemia, Hemolytic etiology, Anticoagulants adverse effects, Child, Child, Preschool, Endocarditis etiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications, Postoperative Hemorrhage chemically induced, Prosthesis Failure, Reoperation, Survival Rate, Thromboembolism etiology, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation mortality
- Abstract
Background: From February 1985 to December 1994, 781 Omnicarbon valve prostheses were implanted in 647 patients. These were 357 male and 290 female patients with a mean age of 53.5+/-10.5 years (range, 4 to 78 years). Before operation, 81% of the patients were in New York Heart Association class III or IV, 16% were in class II, and only 3% were in class I., Methods: There were 227 aortic valve replacements (AVR) (35%), 286 mitral valve replacements (MVR) (44%), and 134 double-valve replacements (DVR) (21%) (AVR + MVR). Follow-up was 96.3% complete and consisted of 2,746 patient-years (mean follow-up, 4.6 years, and maximum follow-up, 10.7 years)., Results: Hospital mortality rates were 7.0% for AVR, 8.0% for MVR, and 8.2% for DVR. The annualized rate of anticoagulant-related hemorrhage was 0.8% per patient-year, and thromboembolism occurred at a rate of 0.7% per patient-year. No structural failure was observed during 10-year follow-up. Twenty-one instances of nonstructural dysfunction (two, pannus growth, and 19, dehiscence) of the Omnicarbon valve occurred in 20 patients, an incidence of 0.8% per patient-year. Hemolytic anemia was observed only in the presence of valvular dehiscence (6 of 19). Eight patients (0.3% per patient-year) had development of prosthetic valve endocarditis (4, AVR; 2, MVR; and 2 DVR). At the end of 10 years of follow-up, 91% of the survivors were in New York Heart Association class I or II. The overall survival rate at 10 years was 82.5%+/-2.6% (85.0%+/-3.9%, AVR; 81.0%+/-4.1%, MVR; and 82.5%+/-2.6%, DVR). Considering only valve-related deaths, the survival rate at 10 years was 91.9%+/-2.4% (90.0%+/-2.7%, AVR; 93.1%+/-3.8%, MVR; and 90.0%+/-1.8%, DVR)., Conclusions: Clinical results over a 10-year follow-up are excellent with the Omnicarbon prosthesis.
- Published
- 1999
- Full Text
- View/download PDF
26. [Cardiac transplant in single ventricle].
- Author
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Osa A, Almenar L, Malo P, Palencia M, García A, Caffarena JM, and Algarra F
- Subjects
- Adolescent, Adult, Female, Humans, Male, Pulmonary Valve Stenosis congenital, Heart Transplantation, Heart Ventricles abnormalities, Pulmonary Valve Stenosis surgery, Transposition of Great Vessels surgery
- Abstract
Univentricular heart is an uncommon congenital heart disease. A select group of these patients (those with severe pulmonary stenosis or atresia) can reach adult age with different degrees of heart failure and severe chronic hypoxemia. Patients with adequate pulmonary tree development are likely to undergo heart transplantation when usual palliative techniques are contraindicated. Three cases of univentricular heart with pulmonary stenosis in which heart transplantation was the optimal choice are reported. Different techniques used to assess pulmonary tree development are analysed.
- Published
- 1998
- Full Text
- View/download PDF
27. [Predictive variables of early mortality after orthotopic heart transplant in adults].
- Author
-
Almenar L, Vicente JL, Torregrosa S, Osa A, Martínez-Dolz L, Gómez-Plana J, Varela F, Palencia M, Caffarena JM, and Algarra F
- Subjects
- Adolescent, Adult, Aged, Cause of Death, Child, Female, Humans, Male, Middle Aged, Multivariate Analysis, Prognosis, Prospective Studies, Retrospective Studies, Time Factors, Heart Transplantation mortality
- Abstract
Objective: The purpose of the study was to analyze some variables of donors, recipients and surgical procedures in order to discover factors that could predict mortality during the early stage (< 30 days) of orthotopic heart transplants., Material and Method: 125 consecutive orthotopic heart transplants in adults were analyzed. The average age was 51 +/- 11 (range: 12-67), 109 (87%) were men, 16 were women (13%). Two groups were compared: 15 patients who died within 30 days after heart transplant and 110 who survived during that period. Immunosuppressive protocol: preoperative: Cyclosporin + Azathioprine. Intraoperative: Methylprednisolone Postoperative: Methylprednisolone (first 24 h), antilymphocyte monoclonal antibodies (7-10 days after heart transplant) + Cyclosporin + Azathioprine + Corticoids. The following parameters of the recipient were analyzed: sex, age, weight, size, thoracic perimeter, pretransplant cardiopathy, previous thoracic operations, functional stage or need for catecholamines during the days prior to the transplant, pulmonary artery pressure and resistance, history of systemic arterial hypertension, elevation of creatinine, blood type, urgent transplant indication, receptor/donor weight relationship. The following parameters of donors and operation were analyzed: sex, age, weight, thoracic perimeter, period in intensive care unit, dose of dopamine and dobutamine, blood type, origin of the organ, cause of death, ischaemia time, cardiopulmonary by-pass time and cardioplegia type., Results: The rate of early mortality was 12%. The univariate analysis showed differences in: prior cardiovascular surgery, receptor blood type, need for urgent transplantation, pulmonary artery resistance > 2.5 Wood Units, cardiopulmonary by-pass time, weight relationship between receptor and donor. The death cause of the donor proved significant. On multivariate analysis, the following parameters independently predicted early mortality: history of operation with extracorporeal circulation, high pulmonary artery resistance, urgent transplant, receptor/donor weight relation and time of extracorporeal circulation., Conclusions: We believe that the results of our experience can help to stratify the risk in the orthotopic heart transplant recipient and even to contraindicate the procedure in some cases showing an accumulation of poor prognostic factors in borderline recipients.
- Published
- 1997
- Full Text
- View/download PDF
28. [Heart angiosarcoma and heart transplantation. Report of a case].
- Author
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Almenar L, Martí S, Navarro M, Roldán I, Chirivella M, Sánchez E, Torregrosa S, Palencia M, Caffarena JM, and Algarra F
- Subjects
- Adult, Fatal Outcome, Female, Heart Neoplasms pathology, Hemangiosarcoma pathology, Humans, Heart Neoplasms surgery, Heart Transplantation, Hemangiosarcoma surgery
- Abstract
We present the case of a 29-year-old women with a cardiac primary angiosarcoma diagnosis. The initial symptom was a cardiac tamponade. The tests for screening metastasis proved negative. She was preoperatively treated with chemotherapy, followed by a heart transplant. There were no incidents related to surgery nor to the transplant except for a rejection in the second week biopsy. Four weeks after the transplant, the patient had a sudden dyspnea, the radiological tests confirmed the existence of a massive pleural overflow and lung and pleural metastasis. All types of therapeutical approaches were rejected except for pleurodesis. The patient died 60 days after the heart transplant.
- Published
- 1996
29. [The use of cryopreserved homografts in reconstructing the right ventricular outflow tract in congenital cardiopathies].
- Author
-
Gómez-Ullate JM, Reyes I, Malo P, Arriaga F, and Caffarena JM
- Subjects
- Adolescent, Child, Child, Preschool, Heart Defects, Congenital mortality, Humans, Postoperative Complications epidemiology, Pulmonary Valve Stenosis mortality, Pulmonary Valve Stenosis surgery, Remission Induction, Transplantation, Homologous, Transposition of Great Vessels mortality, Transposition of Great Vessels surgery, Aortic Valve transplantation, Cryopreservation methods, Heart Defects, Congenital surgery, Pulmonary Valve transplantation
- Abstract
In recent years the use of cryopreserved allograft valves has become very popular. Homograft valves have been used for aortic valve replacement and for reconstruction of the outflow tract of the right ventricle for more than 30 years with very good results. Recently the method of cryopreservation has made possible the creation of valve banks. The use of this cryopreserved valves has obtained very good short and medium term results. We present our experience with the use of cryopreserved allograft valves in the reconstruction of the right ventricular outflow tract in the treatment of complex cardiac malformations. We have operated 15 children. Six were diagnosed of different types of transpositions of the great arteries with ventricular septal defect and pulmonary atresia or stenosis. There were 2 deaths not related to the use of the allograft valves. Nine other patients were diagnosed of different types of complex cardiac malformations. One patient with a univentricular heart and pulmonary stenosis and a neonate presenting with a truncus arteriosus communis died after the operation; again the deaths were not related to the use of the homograft conduits. Our technique of cryopreservation consists in the procurement of aortic and pulmonary valves from multiorgan donor patients. The valves are sterilized in antibiotics for 48 hours. Then the process of freezing is began with a period of progressive cooling down to -40 degrees C and second phase of storage in liquid nitrogen to a temperature of -178 degrees C. The short and medium term results are very satisfactory. We have not seen late important complications.
- Published
- 1992
30. Blunt chest injuries in 1696 patients.
- Author
-
Galan G, Peñalver JC, París F, Caffarena JM Jr, Blasco E, Borro JM, García-Zarza A, Padilla J, Pastor J, and Tarrazona V
- Subjects
- Accidents statistics & numerical data, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Multiple Trauma complications, Spain, Thoracic Injuries etiology, Thoracic Injuries mortality, Treatment Outcome, Wounds, Nonpenetrating etiology, Wounds, Nonpenetrating mortality, Thoracic Injuries therapy, Wounds, Nonpenetrating therapy
- Abstract
We review 1696 patients with blunt chest trauma. Road traffic accidents were the main cause of injury followed by domestic falls and labour accidents. Outdoor falls and sport accidents accounted for a small number of injuries. For clinical evaluation, Stoddart's score was used. The injuries were considered as minor in 710 patients, intermediate in 740 and severe in 246. Global in-hospital mortality was low (5%) but increased to 37% when only patients with multiple severe injuries were considered. Thoracic wall fractures were present in 1419 patients. Flail chest was diagnosed in 140 patients and pulmonary contusion in 275. Diaphragmatic rupture was present in 40 patients and tracheobronchial injury in 6. Cardiovascular injuries occurred in 55 patients. Associated extrathoracic injuries were seen in 611 patients: 923 patients were clinically observed and/or medically treated. An intercostal tube was inserted in 638 patients. Thoracotomy was undertaken in 105 patients. Surgical fixation for flail chest was carried out in 29 patients. The results were generally good: 9 patients did not need any mechanical ventilation and 11 were ventilated for a short period. No deaths were due to the surgical procedure. The authors maintain that a selective attitude restricting, but not ignoring, surgical stabilization is the best policy.
- Published
- 1992
- Full Text
- View/download PDF
31. Bronchial fistula to the mediastinum in a heart-lung transplant patient.
- Author
-
Borro JM, Ramos F, Vicente R, Sanchis F, Morales P, and Caffarena JM
- Subjects
- Adult, Anastomosis, Surgical, Humans, Male, Surgical Staplers, Surgical Wound Dehiscence diagnostic imaging, Suture Techniques, Tomography, X-Ray Computed, Bronchial Fistula diagnostic imaging, Cardiomyopathy, Dilated surgery, Fistula diagnostic imaging, Heart-Lung Transplantation, Hypertension, Pulmonary surgery, Mediastinal Diseases diagnostic imaging, Postoperative Complications diagnostic imaging
- Abstract
We present a case of heart-lung transplantation complicated by bronchial perforation as the cause or consequence of prolonged lung infection. Periodic bronchoscopic and radiological follow-up showed resolution of the condition following adequate antibiotic and physiotherapeutic treatment.
- Published
- 1992
- Full Text
- View/download PDF
32. Management of non-tumoral tracheal stenosis in 112 patients.
- Author
-
París F, Borro JM, Tarrazona V, Casillas M, Galan G, Caffarena JM Jr, and Segui J
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Granuloma surgery, Humans, Laryngoscopy, Male, Middle Aged, Prognosis, Reoperation, Trachea surgery, Tracheal Diseases surgery, Tracheal Stenosis mortality, Tracheal Stenosis therapy, Tracheal Stenosis surgery
- Abstract
From January 1973 to August 1989, 112 patients with non-tumoral tracheal strictures were treated in our unit. In 102 patients, the stenosis followed respiratory support. Eighty-one patients were treated surgically; the rest required only endoscopic therapy. In 28 patients, surgical treatment followed failure of endoscopic management. Of the patients submitted to surgery an isolated tracheal stenosis was present in 54 cases while a laryngotracheal stricture was the lesion in the other 27. Tracheal resection and end-to-end anastomosis was performed in the former group. Rethi, Pearson and Couraud procedures, respectively, were carried out in the latter. We emphasize the difference in the results achieved in the first 5 years and those obtained in the last 10 years. In the former period, 7 reoperations were needed. On the other hand, although the overall mortality of both series was 9%, it decreased to 2% during the last 10 years. Excellent or good ultimate results were achieved in 92% of survivors. Finally, we stress the differences in the proportion of reinterventions and definitive failures in the surgical treatment of isolated tracheal stenosis compared to laryngotracheal strictures.
- Published
- 1990
- Full Text
- View/download PDF
33. [Case report. Right ventricular myxoma simulating pulmonary stenosis].
- Author
-
Gimenez JV, Perez Fernandez E, Pomar F, Blanch S, Mora F, Tormo V, Garcia-Sanchez F, and Caffarena JM
- Subjects
- Adolescent, Diagnosis, Differential, Echocardiography, Heart Neoplasms diagnostic imaging, Heart Ventricles diagnostic imaging, Heart Ventricles pathology, Humans, Male, Myxoma diagnostic imaging, Radiography, Heart Neoplasms diagnosis, Myxoma diagnosis, Pulmonary Valve Stenosis diagnosis
- Published
- 1981
34. L-malposed great arteries with situs solitus and concordant atrioventricular connection.
- Author
-
Coto EO, Castaneda AR, Caffarena JM, Deverall PB, Cabrera A, and Jimenez MQ
- Subjects
- Aorta surgery, Aortic Valve pathology, Heart Conduction System pathology, Heart Septal Defects, Ventricular pathology, Humans, Pulmonary Valve pathology, Pulmonary Valve surgery, Transposition of Great Vessels pathology, Heart Septal Defects, Ventricular surgery, Transposition of Great Vessels surgery
- Abstract
Reports on surgical repair of cases with L-malposition of the great arteries with situs solitus atrialis and concordant atrioventricular connection are uncommon. A review of the anatomical characteristics of these cases has shown several peculiarities that may have considerable important in planning operation. Among them we emphasize the morphology of the ventricular septal defects, possible outflow tract obstructions and coronary artery course, anomalies of the atrioventricular valves and the course of the conduction system. Each of these aspects is reviewed from a surgical viewpoint in the light of our combined previous surgical and anatomical experience and of a review of previous reports by other authors.
- Published
- 1982
35. [Use of expanded polytetrafluoroethylene conduits in the construction of palliative fistulas in children].
- Author
-
Gómez-Ullate JM, Llamas P, and Caffarena JM
- Subjects
- Child, Preschool, Evaluation Studies as Topic, Humans, Infant, Infant, Newborn, Polytetrafluoroethylene, Aorta surgery, Blood Vessel Prosthesis, Heart Defects, Congenital surgery, Pulmonary Artery surgery, Subclavian Artery surgery
- Published
- 1983
36. [Clinical implications of extracorporeal circulation with total hemodilution as affecting renal function during the postoperative period].
- Author
-
Concha Ruíz M, García Sánchez F, Gómez Ullate JM, Peris JJ, Ferrer H, Otero E, Luna D, Montero A, and Caffarena JM
- Subjects
- Diuresis, Humans, Osmolar Concentration, Extracorporeal Circulation, Kidney physiopathology, Postoperative Complications physiopathology, Water-Electrolyte Imbalance etiology
- Published
- 1977
37. [Subclavian auction syndrome caused by occlusion of the brachiocephalic trunk].
- Author
-
Sierra L, Carbonell P, Concha M, Frias R, García-Sánchez F, Gómez-Ullate J, Peris JJ, and Caffarena JM
- Subjects
- Angiography, Humans, Male, Middle Aged, Brachiocephalic Trunk diagnostic imaging, Subclavian Steal Syndrome diagnostic imaging
- Published
- 1974
38. [Direct arterial surgery in the aorto-iliac sector].
- Author
-
Sierra L, Carbonell P, Concha M, Frias R, Garcia-Sanchez F, Gomez-Ullate C, Peris-Pedro JJ, and Caffarena JM
- Subjects
- Adult, Aged, Blood Vessel Prosthesis, Endarterectomy, Humans, Middle Aged, Postoperative Complications, Aortic Diseases surgery, Arterial Occlusive Diseases surgery, Arteriosclerosis surgery, Iliac Artery
- Published
- 1973
39. Late cardiac tamponade after open heart surgery.
- Author
-
Maroñas JM, Otero-Coto E, and Caffarena JM
- Subjects
- Acenocoumarol adverse effects, Adolescent, Adult, Blood Coagulation Disorders complications, Cardiac Tamponade diagnosis, Cardiac Tamponade physiopathology, Echocardiography, Electrocardiography, Female, Humans, Male, Middle Aged, Postpericardiotomy Syndrome complications, Cardiac Tamponade etiology, Heart Valve Diseases surgery, Postoperative Complications
- Abstract
Delayed cardiac tamponade after open heart surgery is relatively uncommon, but constitutes a life-threatening condition that must be diagnosed and managed promptly. We report 21 patients who developed cardiac tamponade 5 to 53 days after open heart operations. Possible etiological factors included anticoagulant therapy (19 patients), excessive mediastinal drainage in the postoperative period (10 patients), postpericardiotomy syndrome (4 patients), and coagulation disorders (1 patient). The clinical presentation was insidious and the diagnosis was often difficult to establish at the outset. A high index of clinical suspicion and echocardiography were the most reliable means to reach an early diagnosis. Twenty patients in whom delayed tamponade was suspected were operated and all of them survived. In one patient tamponade was not diagnosed antemortem and he died; on autopsy left heart compression by a large loculated clot was found. Decompression of the pericardial space can be accomplished by pericardiocentesis or by surgical means (subxiphoid pericardiotomy, median sternotomy, or thoracotomy). Although pericardiocentesis alone may be effective, mainly when the postpericardiotomy syndrome is the suspected etiology, we recommend open procedures since the presence of blood clots and adhesions has been a frequent finding.
- Published
- 1987
40. [Surgical treatment of septal perforation and postinfarct biventricular myocardial aneurysm: contribution of 2 cases].
- Author
-
García Sánchez F, Concha Ruiz M, Frías R, Gómez Ullate JM, Peris Pedro JJ, Ferrer H, Montero A, and Caffarena JM
- Subjects
- Angiocardiography, Cardiac Catheterization, Evaluation Studies as Topic, Heart Aneurysm surgery, Humans, Male, Middle Aged, Rupture, Heart Aneurysm etiology, Heart Ventricles surgery, Myocardial Infarction complications
- Published
- 1974
41. [Postoperative resuscitation in a case of removal of ventricular postinfarction aneurysm with mitral valve replacement (author's transl)].
- Author
-
Vicente JL, Montero Benzo R, Caffarena JM, and Rodríguez Argente G
- Subjects
- Adult, Heart Aneurysm etiology, Heart Rupture, Heart Ventricles, Humans, Male, Mitral Valve Insufficiency complications, Myocardial Infarction complications, Papillary Muscles, Postoperative Complications therapy, Rupture, Spontaneous, Heart Aneurysm surgery, Resuscitation
- Published
- 1981
42. Ebstein's anomaly of the left-sided atrioventricular (AV) valve in AV discordance.
- Author
-
Otero-Coto E, Perez-Martinez V, Palacios V, and Caffarena JM
- Subjects
- Adult, Ebstein Anomaly diagnostic imaging, Ebstein Anomaly pathology, Heart Valve Prosthesis, Humans, Male, Myocardium pathology, Radiography, Tricuspid Valve, Ebstein Anomaly surgery
- Abstract
Prosthetic valve replacement of the left-sided atrioventricular (AV) valve was performed in a patient with AV discordance and Ebstein's anomaly of the left-sided AV valve without other associated anomalies. An anatomical study of 22 specimens with AV discordance did not show a case with similar anatomy; 5 hearts had mild degrees of downward displacement of the attachment of the left-sided AV valve leaflets, with marked dysplastic changes and variable degrees of hypoplasia. The surgical implications are different according to the degree of downward displacement of the leaflets. This feature and the size of the annulus and the morphologically right ventricle should be considered in preoperative evaluation, along with the operative approach, possible presence of atrialization of the wall of the proximal chamber and the relation of the left AV valve to the conduction system. Preoperative diagnosis of the anomaly is possible by angiocardiography and other methods.
- Published
- 1980
- Full Text
- View/download PDF
43. [Interventricular communication and aortic insufficiency. Surgical considerations].
- Author
-
Marońas JM, Otero E, Llamas P, and Caffarena JM
- Subjects
- Adolescent, Adult, Aortic Valve, Aortic Valve Insufficiency complications, Child, Child, Preschool, Female, Heart Septal Defects, Ventricular complications, Humans, Male, Syndrome, Aortic Valve Insufficiency surgery, Heart Septal Defects, Ventricular surgery, Heart Valve Prosthesis
- Published
- 1981
44. Anatomically corrected malposition (surgical repair).
- Author
-
Otero Coto E, Caffarena JM, Gomez-Ullate JM, and Such Martinez M
- Subjects
- Child, Diagnosis, Differential, Heart Defects, Congenital diagnosis, Heart Septal Defects surgery, Heart Ventricles abnormalities, Heart Ventricles diagnostic imaging, Humans, Infant, Newborn, Male, Radiography, Transposition of Great Vessels diagnosis, Heart Defects, Congenital surgery
- Abstract
Anatomically corrected malposition is a rare anomaly usually associated with other complex malformations. However, less complicated cases do occur and we report one such case treated surgically with success. Our experience underlines the importance of careful digital examination of the right ventricle from the atrium to determine the position of the septum, as the position of the left anterior descending coronary artery can be misleading.
- Published
- 1980
45. [Isolated hypoplasia of the left iliac artery].
- Author
-
Sierra L, Carbonell P, Concha M, Ferrer H, Frias R, Garcia-Sanchez F, Gomez-Ullate J, Peris-Pedro JJ, and Caffarena JM
- Subjects
- Aortography, Humans, Iliac Artery diagnostic imaging, Male, Middle Aged, Iliac Artery abnormalities
- Published
- 1974
46. [Iatrogenic trauma of the left subclavian artery. Complex surgical treatment].
- Author
-
Sierra L, Carbonell P, Concha M, Frias R, Garcia-Sanchez F, Gomez-Ullarte J, Peris-Pedro JJ, and Caffarena JM
- Subjects
- Humans, Iatrogenic Disease, Male, Methods, Middle Aged, Postoperative Complications, Raynaud Disease surgery, Subclavian Artery surgery, Subclavian Artery injuries
- Published
- 1975
47. Fatal coronary obstruction due to cloth-wear of a cloth-covered Starr-Edwards aortic valve prosthesis.
- Author
-
Maroñas JM, Such M, Sánchez P, González-Pont G, and Caffarena JM
- Subjects
- Adult, Death, Sudden etiology, Equipment Failure, Humans, Male, Aortic Valve Insufficiency etiology, Heart Valve Prosthesis adverse effects, Myocardial Infarction etiology
- Published
- 1982
- Full Text
- View/download PDF
48. Aorta--right atrial communication. Report of an unusual case.
- Author
-
Coto EO, Caffarena JM, Such M, and Marques JL
- Subjects
- Adult, Aortic Aneurysm diagnosis, Aortic Aneurysm surgery, Aortography, Diagnosis, Differential, Heart Atria surgery, Humans, Male, Aorta surgery, Aortic Aneurysm complications, Heart Atria abnormalities, Vena Cava, Superior abnormalities
- Abstract
An unusual aneurysmal aorta--right atrial communication was found in a 25-year-old man with a rounded mass in the right cardiophrenic angle. Differential diagnoses included ruptured aneurysm of the sinus of Valsalva, coronary arteriovenous fistula, rupture of a dissecting aneurysm of the ascending aorta into the right atrium, and pseudoaneurysm of the right coronary artery followed by formation of a fistula between the aneurysm and the right atrium. Closure of the communication was performed under cardiopulmonary bypass. Complete absence of the right superior vena cava with a large persistent left superior vena cava draining to the coronary sinus was an unexpected finding at operation. The origin of the communication is not known; possible anomalous coronary and noncoronary origins are considered.
- Published
- 1980
49. Double outlet right ventricle with L-position of the aorta, D-loop, subaortic VSD, and pulmonary stenosis.
- Author
-
Caffarena JM, Sanchez FG, Concha M, Gomez-Ullate JM, Peris JJ, Frias R, Otero E, Ferrer H, and Montero A
- Subjects
- Angiocardiography, Aorta pathology, Cardiopulmonary Bypass, Child, Female, Heart Defects, Congenital surgery, Heart Septal Defects, Ventricular surgery, Heart Ventricles, Humans, Myocardium pathology, Pulmonary Valve Stenosis surgery, Heart Defects, Congenital complications, Heart Septal Defects, Ventricular complications, Pulmonary Valve Stenosis complications
- Abstract
We describe a case of double outlet right ventricle with subaortic ventricular septal defect and pulmonary stenosis treated successfully with cardiopulmonary bypass. We consider the clinical history and angiocardiographic and surgical findings of this rare anomaly. We stress the difficulties of reconstruction of the outflow tract of the right ventricle, because of the anomalous pathway of the right coronary artery, the posterior situation of the pulmonary artery, and the abnormal anatomy present in the outflow tract of the right ventricle.
- Published
- 1976
- Full Text
- View/download PDF
50. [Valvular re-operations].
- Author
-
Llamas P, Otero Coto E, Monteagudo Beltrán A, Maroñas JM, and Caffarena JM
- Subjects
- Adolescent, Adult, Aortic Valve, Equipment Failure, Female, Humans, Male, Middle Aged, Mitral Valve, Reoperation, Tricuspid Valve, Heart Valve Prosthesis, Postoperative Complications surgery
- Published
- 1981
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